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ARF and Cor Pulm.
Question | Answer |
---|---|
Acute Respiratory Failure | not a disease but a condition; inadequate gas exchange, lung can not make the O2 demand of tissues |
Signs of ARF | specific or nonspecific; sudden or gradual onset; either decrease in PaO2 or rapid increase in PaCO2 |
PaO2 | partial pressure oxygen or oxygen pressure in arterial blood; free oxygen that has not yet bound to hemoglobin (80-100mmhg) |
SaO2 | oxygen saturation in arterial blood. Once oxygen is bound to hemoglobin, it no longer exerts pressure (greater or equal to 90%) |
PaCO2 | partial pressure CO2, the amount of carbon dioxide present in the arteries (35-45mmhg) |
Hypoxemia vs Hypercapnia | Hypoxemia is not enough O2 in the blood, anything less than 60mmhg. Hypercapnia is not enough CO2 taken out of the blood, so anything greater than 45mmhg. |
Symptoms of Respiratory Failure | Early signs are tachycardia or HTN. Late signs are severe morning headache or cyanosis. |
Consequences of hypoxemia/hypoxia | Metabolic acidosis, cell death, decreased cardiac output, and impaired renal function |
Clinical Manifestations of Resp Failure | rapid shallow breathing; tripod position; dyspnea; pursed-lip breathing; retractions; change in I/E ratio |
Ventilation-Perfusion Mismatch | volume of blood perfusing the lungs each minute (4-5L); this fails to match the fresh gas that reaches the alveoli, so glood and gas don't match...causes: COPD, pneumonia, asthma, atelectasis, PE |
Shunt | blood exits the heart w/o having participated in gas exchange; there are 2 types: Anatomic shunt (ventricular/septal defect) and Intrapulmonary shunt (b/c of fluid filled alveoli; ARDS, pneumonia, and PE) |
diffusion Limitation | gas exchange is compromised b/c a process has thickened or detroyed the membrane; severe emphysema, pulmonary fibrosis, recurrent PE, hypoxemia present during exercise |
Alveolar Hypoventilation | decrease in ventilation that results in an increase in PaCO2 and decrease in PaO2, its a mechanical in PaO2; restrictive lung disease, CNS disease, chest wall dysfunction, and neuromuscular disease |
Cor Pulmonale | enlargement of the R ventricle (right-sided heart failure); secondary to disease of the lung, thorax, or pulmonary circulation; causes: pulmonary HTN, cardiac failure, and COPD (most common) |
Clinical Manifestations of Cor Pulmonale | dyspnea; chronic productive cough; wheezing; retro/substernal pain; fatigue |
clinical Manifestations of heart failure | peripheral edema 3+, weight gain, JVD, full & bounding pulse, enlarged liver |